Monday, April 27, 2009

The Year of the Swine

1976. The generation of public health professionals who eradicated Smallpox were still around. They hadn't eradicated anything lately. AIDs hadn't hit yet. It was a slow year.

Somebody noted that flu epidemics come in 11-year cycles, but that pandemics, like 1918, come in 60-year cycles. Somebody else did the math and said, "We're due now for a big one."

A search showed that two individuals in the United States had been infected in the previous couple of years with Swine Flu, the same flu that was thought to have caused the pandemic. Both of these individuals, however, had been in close contact with pigs and that cast the matter in doubt. It was generally agreed that we were OK as long as the victims had been with pigs.

Then, at Fort Dix, New Jersey, healthy recruits started coming down with the flu. Swine Flu. A quick surveillance revealed that no Fort Dix recruit had been with a pig. People in Atlanta started getting excited.

I found myself in the State of Delaware, running a state-wide Swine Flu Immunization Program. It was part of a national campaign to vaccinate everybody.

I marshaled resources and gathered troops and organized meetings. Everybody was in favor of the program, except this one guy who came to all the meetings and kept asking questions about how I was doing everything. And why.

After one of these meetings, I asked him if he worked for the Health Department. He said, no, he was unemployed. I asked him if he wanted a job. He said, sure. So I put him in charge of running the program. For $12,000.

His name was Allen Kagel and he did a top-notch job. When the program began, people started lining up all over the State. All I had to do was appear on the local news.

On December 16, Kagel invited me up to an elementary school in Wilmington to observe the operation he had set up there. When I arrived, the parking lot was full. Lines of people snaked around and through the halls back to the school clinic where the vaccination stations were. I saw one man, inching his way up on a pair of wooden crutches. He grinned at me when he passed by.

A little while later, I got a call from Dover. My office had reached the Principal's office at the school, where Kagel had his command post. He took the call, but then handed it over to me. I listened to the message as it had been transmitted from Atlanta. And then I said, "OK."

I looked at Kagel and said, "The National Program has been terminated."

As I considered my next move, Kagel seized the microphone of the school intercom and bellowed, "THE NATIONAL SWINE FLU PROGRAM HAS BEEN CANCELED."

What happened next was a rush for the exits.

I said, "What are we going to do with all these people?"

Kagel said, "What people?"

The hall, which had late been full of eager vaccinees, was empty. I went to the window. The parking lot was empty.

And, a block away, I saw the figure of a man, with crutches akimbo, making it around the corner.